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Islanded facial artery musculo‐mucosal flap for partial pharyngeal defect reconstruction after total laryngectomy: Case report
Author(s) -
Akali Nisha Rajrattansingh,
Jaya Arya Chandrababu,
Balasubramanian Deepak,
Iyer Subramania,
Thankappan Krishnakumar
Publication year - 2021
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.26522
Subject(s) - medicine , swallowing , surgery , fistula , pharynx , laryngectomy , facial artery , larynx
Background Partial pharyngeal defect reconstruction after total laryngectomy with regional and free fasciocutaneous flaps has been described. However, mucosal flaps for such defects have not been reported. Methods An islanded facial artery musculo‐mucosal (FAMM) flap was used to reconstruct a partial pharyngeal defect after total laryngectomy. Surgical, swallowing, and speech outcomes were analyzed at 6 months postoperatively. Results At 6 months, videofluoroscopy showed no post swallow residue, fistula, trachea‐esophageal puncture leak, or stricture. Perceptual analysis of recorded cold speech, native language passage sample, and the intelligibility analysis was good. The patient had normal mouth opening and marginal mandibular nerve function. Conclusion Islanded FAMM flap is ideal for partial pharyngeal defects, which cannot be closed primarily. Speech and swallowing outcomes were good. It provided a robust and predictable blood supply and adequate reach. There was no significant donor site morbidity. The musculo‐mucosal flap replaced “like‐with‐like” tissue.